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SAN J O A Q U I N Environmental Health Department <br /> 01 U <br /> Corrective Action Statement <br /> RE: July 05, 2023, Underground Storage Tank inspection report <br /> For each violation listed below, indicate if the violation has been corrected or will be corrected by a certain date. Also, <br /> describe what was done to correct the violation in the space provided below each violation. Submit this completed form <br /> with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please contact <br /> Vicky Vang-Lee at(209)616-3028 or vvang-lee@sjgov.org. <br /> Facility name: S B GAS&MARKET Submit completed form to: <br /> Facility address: 515 W ELEVENTH ST STE 301 SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10181209 ATTN: VICKY VANG-LEE <br /> PR0231400 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#101 -Failure to obtain a permit to operate from the EHD including but not limited to unpaid <br /> permit fees. <br /> ❑ This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> Violation#102-Failure to submit a complete and accurate application for a permit to operate a UST. <br /> o/ <br /> This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> Violation#104-Failure to submit a complete and accurate UST Monitoring Plan. <br /> ,A' This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> Page 2 of 7 <br /> Rev.9/16/2020 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />